Provider Demographics
NPI:1205946787
Name:ORAL AND MAXILLOFACIAL SURGEONS INC
Entity type:Organization
Organization Name:ORAL AND MAXILLOFACIAL SURGEONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:KRAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:314-569-2201
Mailing Address - Street 1:456 N NEW BALLAS RD
Mailing Address - Street 2:SUITE 249
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6831
Mailing Address - Country:US
Mailing Address - Phone:314-569-2201
Mailing Address - Fax:314-569-2320
Practice Address - Street 1:456 N NEW BALLAS RD
Practice Address - Street 2:SUITE 249
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6831
Practice Address - Country:US
Practice Address - Phone:314-569-2201
Practice Address - Fax:314-569-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO135601223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT70963OtherMEDICARE ID- TYPE UNSPECIFIED- DR KRAM
MO111519OtherCIGNA HMO DR ABRAMS
MO111520OtherCIGNA HMO DR KRAM
MO29075OtherBCBS MED DR ABRAMS
MO29086OtherBCBS MED DR KRAM
MOT80996OtherMEDICARE ID- TYPE UNSPECIFIED- DR ABRAMS
MO111520OtherCIGNA HMO DR KRAM